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45 Gy is not sufficient radiotherapy dose for Group III orbital embryonal rhabdomyosarcoma after less than complete response to 12 weeks of ARST0331 chemotherapy
Author(s) -
Ermoian Ralph P.,
Breneman John,
Walterhouse David O.,
Chi YuehYun,
Meza Jane,
Anderson James,
Hawkins Douglas S.,
HayesJordan Andrea A.,
Parham David M.,
Yock Torunn I.,
Donaldson Sarah S.,
Wolden Suzanne L.
Publication year - 2017
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26540
Subject(s) - medicine , embryonal rhabdomyosarcoma , rhabdomyosarcoma , chemotherapy , radiation therapy , complete response , oncology , radiology , sarcoma , pathology
Background Recent Children's Oncology Group (COG) trials tested the efficacy of reduced therapy in an effort to lessen late effects compared to the Intergroup Rhabdomyosarcoma Study (IRS) IV regimen with associated hematologic and hepatic toxicity, and infertility. Here, we analyze the efficacy of 45 Gray (Gy) local radiotherapy (RT) in patients with Group III orbital embryonal rhabdomyosarcoma (ERMS) enrolled on the COG low‐risk study ARST0331. Procedure Sixty‐two patients with Group III orbital ERMS were treated on ARST0331 with four cycles of vincristine (VCR), dactinomycin (DACT), and cyclophosphamide (CPM; VAC, total cumulative CPM dose 4.8 g/m 2 ) followed by four cycles of VCR and DACT over 22 weeks. Forty‐five Gray of radiation was administered in 25 fractions beginning at week 13 of therapy. Results Fifty‐three patients were evaluable for this response analysis; seven had missing week 12 response evaluation data and two had progressive disease prior to starting RT. Median follow‐up was 7.8 years. None of the 15 patients with radiographic complete response (CR) compared to 6 of the 38 patients with